PHARMACY: New hope for people with ringing in the ears

PEOPLE'S PHARMACY

JOE AND TERESA GRAEDON, King Features Syndicate

Published
5:30 am CST, Monday, March 27, 2006

Is there anything more annoying than hearing a mosquito buzzing around your head and not being able to catch it? A dentist's drill might be a close match. Now imagine what it would be like to have crickets chirping in your ear 24 hours a day, seven days a week.

Millions of people with tinnitus hear a constant noise in their ears. Some describe the sound as hissing, humming, chirping, squeaking or roaring. Many tinnitus victims talk about a high-pitched ringing. Others complain of radio static or an electronic whine.

The sounds never let up, but nobody else can hear them. People with tinnitus look normal, but the affliction can be as crippling as arthritis. Some people are so distressed by the sounds that they become severely depressed and contemplate suicide.

We heard from one wife: "My husband has a constant buzz in his ears and also hears a sound he likens to a dishwasher running. This particular sound bothers him most when he goes to bed or wakes up at night, and it wakes him frequently. The doctor says lots of people have tinnitus and the problem isn't serious, but it has my husband on the ropes."

The cause of tinnitus remains somewhat mysterious. Traumatic noise, such as an explosion, can trigger lifelong tinnitus as well as hearing loss.

Drugs can also bring on ringing. Aspirin and other anti-inflammatory drugs can cause it. So can some antibiotics and antidepressants.

In rare instances, tinnitus may signal a serious condition called acoustic neuroma. This tumor of the acoustic nerve should be ruled out with a test.

What can be done for tinnitus? More than 10 years ago, investigators suggested that Xanax (alprazolam) could improve life for people with disabling tinnitus. We don't know if this anti-anxiety drug actually affected the sound, or if it just helped them cope with it better. It has not been widely adopted as a treatment.

A new study suggests that a natural compound called melatonin might be helpful. This hormone is produced by the brain and is important for establishing the sleep cycle.

Researchers at Washington University found that patients taking 3 mg of melatonin one to two hours before bedtime both slept better and suffered less from their tinnitus (Otolaryngology — Head & Neck Surgery, February 2006). An earlier melatonin study had found similar benefit (Laryngoscope, March 1998).

One reader wrote that he found zinc citrate or zinc methionine supplements helpful. Research supported his observation that 50 mg of zinc daily may reduce tinnitus severity (Otology and Neurotology, January 2003).

A medication prescribed to protect the stomach from ulcers may also provide benefit for tinnitus sufferers. One small, controlled trial of Cytotec (misoprostol) found that it worked twice as well as placebo to relieve tinnitus loudness (Otolaryngology — Head & Neck Surgery, May 2004). Cytotec can cause diarrhea, abdominal pain, nausea and flatulence. It can also cause premature labor or miscarriage, so pregnant women must avoid it.

Although a cure for tinnitus remains elusive, these measures might help some victims. People who don't suffer this devastating condition should protect their precious hearing from loud noises and drugs that may do damage.

The People's Pharmacy Q&A

Q:
I have the attention span of a flea and have been diagnosed with ADD. My doctor prescribed Adderall to try and improve my ability to focus.

I don't find that it helps very much, and I worry that I might be at risk for heart problems. I do have high blood pressure. Are there safer medications I could ask my doctor about?

A: Your concerns are not unjustified. An expert panel for the Food and Drug Administration recently proposed stronger warnings for drugs prescribed to treat attention-deficit hyperactivity disorder. Stimulant medications such as amphetamine (Adderall) and methylphenidate (Concerta, Metadate, Ritalin) may raise blood pressure and increase the risk of heart attack, stroke or sudden death.

Since you already have hypertension, taking amphetamine could counteract the effectiveness of your blood pressure drugs. You may want to ask your physician about nonstimulant alternatives that won't affect your heart.

Q: Your article linking cholesterol medications to memory loss was not based on evidence. There are no studies showing that these drugs have a negative effect. Instead you used letters from readers, which are not scientific. I am concerned that some of my patients may have discontinued their cholesterol medicine.

A: We agree that these drugs can be valuable in preventing heart attacks and strokes. Most people can take them without complications. Those who experience difficulties, however, deserve to have their concerns taken seriously. No one should discontinue without consulting a physician.

We have heard from hundreds of readers who have had severe muscle pain and weakness as side effects of these medicines. Many others have written about memory problems or cognitive difficulties. We have received too many case reports of transient global amnesia to ignore. In this frightening condition, people temporarily lose memory of significant blocks of time.

We are sending you a one-hour CD of a radio interview we conducted with physicians who have studied this effect. Anyone who would like a copy of this CD, "The Dark Side of Statins," may send $16 to: People's Pharmacy (CD-523), P.O. Box 52027, Durham, NC 27717-2027 or visit our Web site, www.peoplespharmacy.com, and look for radio show No. 523.

Q: When I get a cold, it often becomes a sinus infection. The congestion is uncomfortable, but the headache is what really bothers me. Any suggestions for breaking this curse?

A: Another reader shared his approach to sinus headaches: "I use nasal saline for sinus headaches. Nasal saline was first recommended to me by my ear, nose and throat doctor. Ocean Mist is the brand-name OTC product. Xlear is a version with xylitol. Both come in small spray bottles. Generic versions of Ocean Mist can be found at most pharmacies for less than $3. Xlear is about $12 per bottle."

Q: You had a question from a woman suffering vaginal dryness. I am using Estring, an estradiol ring. After 18 months, I have experienced no side effects, and my dryness is gone.

A: Estring is a prescription vaginal ring that releases 2 mg of estradiol over three months. It is convenient, and the dose of estrogen is quite low.

Q: I wonder whether some additive to Earl Grey tea might cause muscle pain and cramping. I am a yoga teacher with a generally mobile body. During the past couple of years, I have suffered worsening muscle pain, cramping and restricted movement. Medicine, acupuncture, physical therapy and massage all failed to provide lasting improvement.

When a recent flulike episode caused me stomach distress, I gave up my two cups of Earl Grey with breakfast and switched to regular orange pekoe tea. Within two weeks, all symptoms were gone and mobility was restored.

I am still drinking tea and have made no other conscious changes, so it seems that the Earl Grey tea is somehow the cause of my problems. What is there in Earl Grey that could set up this reaction?

A: A doctor in Austria published a case report on a 44-year-old man who developed severe muscle cramps in his feet and legs after he started drinking a lot of Earl Grey tea (The Lancet, April 27, 2002). The patient also had muscle twitching, but all the tests on the work-up were normal. When he stopped the Earl Grey tea, his symptoms also disappeared.

Earl Grey tea is flavored with bergamot oil, from the citrus fruit bergamot. It contains a compound called bergapten that can block potassium channels. Potassium flow in and out of the cells is crucial for muscle function, and this presumably explains why too much Earl Grey tea could cause muscle cramps.

Q: The lady who was concerned about her husband's hot food causing an ulcer should ease up. My stomach used to bother me until I started using jalapeño peppers, salsa and Tabasco sauce on scrambled eggs, hash browns, pinto beans and spaghetti sauce. I have no more stomach problems.

A: Despite its reputation, spicy food does not necessarily cause ulcers. Animal research suggests that the essence of chili peppers (capsaicin) may even help protect the stomach from aspirin damage.

Q: I am concerned about elderly people taking medical advice from their well-intentioned but completely unqualified children. My adult siblings convinced our parents to take herbs and supplements with no comprehension of how these might interact with prescribed medicines. My sibs believe they know as much or more than doctors.

My father died last year with liver complications. I hate to think of all the CoQ-10, echinacea, ginkgo, etc., that went through that vital organ. No amount of reasoning could counteract both my parents' faith in their children's advice over their doctors'.

Is there any way to let elderly people know that their prescription drugs might interact with herbs their kids recommend?

A: Your fears are completely justified. Herbs and dietary supplements can interact with many prescription medications. Certain combinations can be lethal. Unfortunately, physicians and pharmacists may not always be aware of such incompatibilities.

People can help prevent such complications by doing their own homework. We have addressed this issue in our 600-page paperback book, "The People's Pharmacy Guide to Home and Herbal Remedies." If you would like a copy, please send $6.99 plus $3 postage and handling to: Graedons' People's Pharmacy, Dept. HHR, P.O. Box 52027, Durham, NC 27717-2027. It can also be ordered from our Web site.